Information Collection

Sponsors and Sites

IC 211308 under ICR 201411-0584-002 · OMB 0584-0595.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Appendix F1 Sponsor Survey Instrument.docx	Other-Appendix F1 Sponsor Survey Ins
Appendix G1 Site Survey Instrument.docx	Other-Appendix G1 Site Survey Instru
Appendix A1 Online Survey Screen Shots for OMB.docx	Other-Appendix A1 Online Survey Scre
Appendix F2 Sponsor MOU.doc Appendix F2 Sponsor MOU	IC Document
Appendix F3 Sponsor Survey E-mail Invite Text-Script.docx Appendix F3 Sponsor Survey E-mail Invite Text-Script	IC Document
Appendix F4 Sponsor Intro Letter.docx Appendix F4 Sponsor Intro Letter	IC Document
Appendix F5 Sponsor Survey Reminder Text-Script.docx Appendix F5 Sponsor Survey Reminder Text-Script	IC Document
Appendix F6 Sponsor Webinar.pptx Appendix F6 Sponsor Webinar	IC Document
Appendix F7 Sponsor Webinar Save the Date.docx Appendix F7 Sponsor Webinar Save the Date	IC Document
Appendix G2 Site Survey E-mail Invite Text-Script.docx Appendix G2 Site Survey E-mail Invite Text-Script	IC Document
Appendix G3 Site Intro Letter.docx Appendix G3 Site Intro Letter	IC Document
Appendix G4 Site Survey Reminder Text-Script.docx Appendix G4 Site Survey Reminder Text-Script	IC Document
Appendix G5 Site Info Request.docx Appendix G5 Site Info Request	IC Document
Appendix B2 Sponsor Informational Brochure.pdf Appendix B2 Sponsor Informational Brochure	IC Document
Appendix B3 Site Informational Brochure.pdf Appendix B3 Site Informational Brochure	IC Document

IC Title:

Sponsors and Sites

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Appendix F1 Sponsor Survey Instrument	www.surveymonkey.com	Yes	Yes	Fillable Fileable Signable
Other-Appendix G1 Site Survey Instrument	www.surveymonkey.com	Yes	Yes	Paper Only
Other-Appendix A1 Online Survey Screen Shots	www.surveymonkey.com	Yes	Yes	Fillable Fileable Signable

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 650

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 90 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	4,469	0	-4,732	9,201
Annual IC Time Burden (Hours)	2,221	150	0	2,071
Annual IC Cost Burden (Dollars)	0	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Appendix F2 Sponsor MOU		04/23/2014
Appendix F3 Sponsor Survey E-mail Invite Text-Script		04/23/2014
Appendix F4 Sponsor Intro Letter		04/23/2014
Appendix F5 Sponsor Survey Reminder Text-Script		04/23/2014
Appendix F6 Sponsor Webinar		04/23/2014
Appendix F7 Sponsor Webinar Save the Date		04/23/2014
Appendix G2 Site Survey E-mail Invite Text-Script		04/23/2014
Appendix G3 Site Intro Letter		04/23/2014
Appendix G4 Site Survey Reminder Text-Script		04/23/2014
Appendix G5 Site Info Request		04/23/2014
Appendix B2 Sponsor Informational Brochure		12/15/2014
Appendix B3 Site Informational Brochure		12/15/2014

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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